PATIENT ACCESS MANAGER FTE 1.00 Days

Job Type

Full-time

Description

The Patient Access Manager must be competent in the following: registering, scheduling, financial counseling, and switchboard functions. In collaboration with Scheduling Manager and Coordination Center Supervisor, the Regional Manager is responsible for oversight, direction and coordination of staff and assigned activities for the Coordination Center and Outpatient Scheduling. In collaboration with the Director, the Patient Access Manager will oversee patient access in their departments, make recommendations for continuous improvement and monitor financial stability of each location they oversee including effective management of revenue cycle metrics, dashboards, KPIs and budget compliance. The Patient Access Manager will meet with their direct reports and Director regularly. They will be responsible for mentoring, development and growth and will collaborate with the OP Scheduling Manager and Coordination Center Supervisor to resolve employee related issues and will work to ensure patient satisfaction, efficient processes, effective use of resources, continuous improvement and uphold the vision and values of Riverside Healthcare.

Essential Duties

• Oversight for departmental records data and processes transactions to ensure that an accurate historical patient database is maintained for each registration encounter.
• In collaboration with the Director, recommends and develops policies and procedures for Patient Access/ registration for the continuum related to payors, workflows, and required data for registration.
• Ensures staff accurately collects and analyzes all required demographic, insurance/financial and clinical data necessary to schedule, pre-register and register patients from all payer classes, interacts with patients, their representatives, physicians, physician office staff, employers, and others, and review new and previously recorded information, electronically records information on a timely basis, follows EMTALA, HIPAA, payer and other applicable regulations and standards for registration.
• Ensures staff analyzes available documentation and uses hospital resources to provide the amount expected from the payer and the amount owed by the patient or responsible party.
• Provides the information to patients to ensure they understand the policies that govern the revenue cycle and the processes that will be followed.
• Monitors reports to ensure compliance and provides education to staff when gaps are identified.
• Ensures staff explains, secures, and witnesses all signatures required to provide medical treatment, assignment of benefits, release of information, establish financial responsibility and to assist in meeting other internal, regulatory and payer requirements.
• Ensures staff reviews physician orders and other documentation against payer coverage and medical necessity criteria, uses screening software to determine whether services being provided meet third-party requirements for payment, contacts physicians as necessary for additional clinical information, informs physicians about payer requirements, initiates Medicare ABN process as appropriate and explains payer policies to patients.
• Documents in notes all financial expectations of payer or patient and medical necessity verification.
• Has a thorough knowledge of the ADT system, switchboard and other communication software.
• Has a thorough understanding of regulations: EMTALA, HIPAA, UB guidelines, DNV, and payors to ensure compliance and educations for staff. Implements and develops policies related to codes for the health system.
• Mentors and develops direct reports and staff. Provides daily, monthly and annual feedback to ensure growth, development, and performance management are ongoing.
• Oversees departmental expenses such as SMR and operational expenses.
• Oversees and maintains assigned work queues keeping them within 24-28 hours.
• Insures staff are correcting patient WQ errors and monitoring their personal registration dashboards.
• In collaboration with direct reports and Director, provides education regarding Emergency Management topics and complete monthly Staff Knowledge Drills.
• Completes monthly report on time for Director.
• Encourage and promotes teamwork among all departments and services within the facility.
• Maintain DNV and ISO 9001 compliance.
• Ensures that office space, supplies, equipment and assistance are provided and maintained appropriately for staff and patient care.
• Financial Responsibilities Include: Monthly dashboard and site P & L and reviewing the reports with each direct report and Director.
• The Patient Access Manager should have a high level of understanding of all reports so they can answer questions.
• Reviews processes and makes recommendations for improvement.
• Creates goals for operations and ensures these goals are aligned with organizational goals.
• Operates within the context of an established budget.
• Makes recommendations for annual budget and maximizes opportunities to meet and exceed budget guidelines.
• In collaboration with director and where applicable, evaluates performance and recommends merit increases, promotions, and disciplinary actions.
• Work with Human Resources and Director on all employee issues.
• Purposely explains the `why' in communications to promote understanding and engagement of team members.
• Review and approve time cards in timekeeping system for direct reports and monitor or review timecards for all locations.
• Where applicable, works with department director regarding decisions with system-wide implications.

Requirements

Required Experience

• Three to five years of medical practice or office management experience including at least two years in a health care organization.
• Effective at leading, coaching, and mentoring staff to bring greater value to organization
• Ability to do general arithmetic
• Detail oriented, committed to accuracy, and ability to problem solve

Preferred Experience

• Prior management experience desired
• Medical Terminology preferred

Required Licensure/Education

• Bachelor's degree in health or business administration or related field required within 5 years of hire.

Preferred Education

• Master's degree in health care, business administration or related field preferred.
• Strong computer skills preferred

Employee Health Requirements

Exposure/Sensory Requirements

• Exposure to:
• Chemicals: None
• Video Display Terminals: Average
• Blood and Body Fluids: Performing ER and Admitting registrations have the potential to be exposed.
• TB or Airborne Pathogens: Performing ER and Admitting registrations have the potential to be exposed.

Sensory requirements (speech, vision, smell, hearing, touch):

• Speech: Required to communicate during presentations/training, telephone communication, and facilitate meetings.
• Vision: Needed to read memos and literature, close vision (ability to adjust focus).
• Smell: NA
• Hearing: Needed for telephone communication, meetings, alarms and listening to employee concerns.
• Touch: Needed to write, computer entry, filing.

• Activity/Lifting Requirements
• Average Hours per Week: 40
• Shift: Varies

Percentage of time during the normal workday the employee is required to:

• Sit: 50-88%
• Twist: 5%
• Stand: 1%
• Crawl: 0%
• Walk: 12-50%
• Kneel: 0%
• Lift: 0%
• Drive: 0%
• Squat: 0%
• Climb: 0%
• Bend: 5%
• Reach above shoulders: 2%

The weight required to be lifted each normal workday according to the continuum described below:

• Up to 10 lbs: Frequently
• Up to 20 lbs: Frequently
• Up to 35 lbs: Occasionally
• Up to 50 lbs: Not Required
• Up to 75 lbs: Not Required
• Up to 100 lbs: Not Required
• Over 100 lbs: Not Required

Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):

Carrying materials such as charts and labels waist high and for approximately 20 feet.

Maximum consecutive time (minutes) during the normal workday for each activity:

• Sit: 30
• Twist: 1
• Stand: 5
• Crawl: 0
• Walk: 5
• Kneel: 0
• Lift: 0
• Drive: 0
• Squat: 0
• Climb: 0
• Bend: 0
• Reach above shoulders: 1
• Repetitive use of hands (Frequency indicated): Simple grasp up to 10 lbs. Normal weight: 5-10# frequent
• Pushing & pulling Normal weight: 50#
• Fine Manipulation: Computer keyboard, writing, calculator.
• Repetitive use of foot or feet in operating machine control: Not Required

Environmental Factors & Special Hazards

• Environmental Factors (Time Spent):
• Inside hours: 8
• Outside hours : 0
• Temperature: Normal Range
• Lighting: Average
• Noise levels: Average
• Humidity: Normal Range
• Atmosphere:
• Special Hazards:
• Protective Clothing Required: None

Salary Description

$83,408.00-$108,409.60/yearly